The largest study of its type in the world has confirmed that asthma is associated with childhood fractures for boys, but not girls, underlining the importance of bone health education.
More than 334 million people globally are estimated to have asthma. In children, approximately one in seven are reported to have asthma symptoms, with boys having the highest prevalence in children aged under 10yrs, and girls in those aged over 10yrs.
The University of Melbourne-led study, of more than 16,000 primary school children aged from 3yrs to 14yrs, found that boys with moderately severe asthma were 30 per cent more likely to fracture a bone than boys without the lung condition.
The same association was not found in girls, although older girls with asthma did have an increased risk of fracture. The researchers suggest girls with asthma may have fewer fractures due to faster maturing bodies. Another contributing factor is the differences in risk-taking behaviours between boys and girls at certain ages.
Importantly the researchers found that the use of inhaled corticosteroids did not influence the association between asthma and increased risk of fractures in boys. It is suggested by Dr Brennan-Olsen, the lead researcher of the study, that the underlying disease process of asthma may influence bone development in children. As asthma is an inflammatory disease it can lead to bone loss by interfering with mechanisms in bone formation and reabsorption.
The recommendations from the researchers are for asthmatic children to remain physically active for good bone health and not to stop taking preventative medications, as unfortunately there are not many preventative measures that can be taken other than to be aware of the increased risk of fractures.
Citation:
Degabriele, E. L., Holloway, K. L., Pasco, J. A., Hyde, N. K., Vuillermin, P. J., Williams, L. J. and Brennan‐Olsen, S. L. (2018), Associations between asthma status and radiologically confirmed fracture in children: A data‐linkage study. J Paediatr Child Health. . doi:10.1111/jpc.13895
